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ACH Authorization Form

Authorization Agreement for Preauthorized Electronic Withdrawals

The ACH automatic withdrawal payment option is a free, convenient, hands-free way to ensure you never miss a payment. The same amount is withdrawn from your checking or savings account on the last business day of each month. 

Please complete the ACH Authorization and mail or drop in our box at the City Market Customer Service counter. You can also email to Tara Espinoza:

Printable ACH Authorization Form


ACH Agreement

I hereby authorize Buena Vista Sanitation District to initiate debit entries to my Checking/Savings account for the purchase of paying the monthly sewer bill to Buena Vista Sanitation District.

Said debit will occur the last business day of the month.

Service Address

Call 719-395-8095 during business hours to provide bank routing and account numbers.
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